An ostomy bag, or pouching system, serves as an external collection device for bodily waste that is diverted through a surgically created opening called a stoma. This system allows individuals to manage waste output from their digestive or urinary systems when normal function is not possible. The appropriate schedule for changing an ostomy bag is not uniform for everyone and is influenced by several individual factors.
Factors Influencing Change Frequency
The type of ostomy is a primary determinant, as different procedures result in varying output characteristics. For instance, an ileostomy typically produces more liquid and frequent output compared to a colostomy, which often yields more solid and less frequent stool. Urostomies, which manage urine, have continuous liquid output. This difference in output volume and consistency directly influences how quickly the adhesive barrier might erode or how full the pouch becomes.
The condition of the skin around the stoma, known as peristomal skin, also plays a significant role. Healthy peristomal skin should be free from redness, irritation, or breakdown. If the skin becomes irritated, moist, or damaged, it can compromise the seal of the ostomy appliance, requiring more frequent changes to prevent further issues and ensure proper adhesion.
The type of pouching system used also impacts wear time. One-piece systems, where the pouch and skin barrier are combined, are generally changed more frequently than two-piece systems, which allow the pouch to be changed while the skin barrier remains in place for several days. Personal preferences and lifestyle factors, such as activity levels, climate, and skin type, also contribute to how long an ostomy system can be worn.
General Guidelines for Pouch Types
Closed pouches, typically used by individuals with colostomies due to more formed stool, are designed for single use. These are generally changed and discarded after each bowel movement or when one-third to one-half full, often resulting in one to three changes per day.
Drainable pouches, commonly used for ileostomies and some colostomies due to their more liquid or pasty output, are emptied multiple times a day as they fill. The entire pouching system, including the skin barrier, is typically changed every three to five days. Some individuals may extend this to seven days, depending on the product and their skin health.
Urostomy pouches, which collect urine, are drained frequently throughout the day and night. The full urostomy pouching system is usually changed every three to seven days, similar to drainable pouches for fecal ostomies. Consulting with a healthcare professional, especially an ostomy nurse, can help determine the most appropriate changing schedule.
Signs It’s Time to Change
Beyond a routine schedule, several indicators suggest an immediate ostomy bag change. Leakage is a primary sign, requiring prompt attention to prevent skin damage and discomfort. If output is visible on the skin around the stoma or on the back of the adhesive plate, the seal has been compromised.
Discomfort around the stoma area, such as itching, burning, soreness, or pain, can signal irritation or a failing seal. This discomfort might indicate that effluent is coming into contact with the peristomal skin, which can quickly lead to breakdown. Visible signs of wear on the pouch or adhesive, such as the edges of the wafer lifting or “melting” due to contact with output, also indicate a need for a change.
For closed pouches, a full pouch requires changing to prevent strain on the adhesive and potential leaks. Any redness, rash, or visible breakdown of the peristomal skin should prompt a change and assessment, as healthy skin is crucial for preventing complications. An unusual or persistent odor may also suggest the pouch’s filter is compromised or a leak.